Download Absence - Communicable Diseases

SUMMARY OF RECOMMENDED PERIODS OF ABSENCE
FOR COMMUNICABLE DISEASES
SCHOOL PUPILS
Health Protection Team, Lothian NHS Board, Waverley Gate, 2-4 Waterloo Place, Edinburgh, EH1 3EG
Enquiries 0131 465 5420/5422
HPT F059 04
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Introduction
In accordance with national guidance, this document provides a summary of the recommended periods of absence for school
pupils who are, or are thought to be, suffering from an infection which may spread to others.
The key to prevention and control of spread of infection is maintaining high standards of hygiene at all times. In particular:
Hands should be washed after:
• Using or cleaning the toilet
• Immediately after handling raw meat/poultry
• Preparing food in general
• Blowing your nose or covering a sneeze or cough
• Smoking, as fingers will come in contact with the mouth and nose
• Touching pets or other animals
Hands should be washed before:
• Preparing food or drink
• Eating food
High standards of hygiene should also be applied to:
• Food hygiene
• Environmental cleaning
• Disposal of waste.
For further information and advice on infectious diseases and the control of infection, contact the Health Protection Team, Lothian
NHS Board.
Tel: 0131 465 5420/5422
Also please refer to Infection Prevention and Control in Childcare Settings (Day Care and Childminding Settings) produced
by Health Protection Scotland which is available here:
http://www.documents.hps.scot.nhs.uk/hai/infection-control/guidelines/infection-prevention-control-childcare-2015-v2.pdf
HPT F059 04
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Key for recommended period of absence:
Groups that pose a higher than normal risk of spreading infection.
Group A
Any person of doubtful hygiene or with unsatisfactory toilet, hand washing or hand
drying facilities at home, work or school.
Group B
Children who attend pre-school groups or nursery
Group C
People whose work involves preparing or serving unwrapped foods not subjected
to further heating/cooking.
Group D
Health or Social Care staff who have direct contact with highly susceptible patients
or persons in whom an infection would have particularly serious consequences.
HPT F059 04
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Campylobacter
3-4 Days
(Can be 1-10 days).
Food borne.
Contaminated food
and water.
Contact with infected
animals.
Low risk of transmission
from person to person
can occur, especially
where there is poor
hygiene practice.
Until clinically
recovered and
diarrhoea has ceased
for 48hrs.
None
Practice good hygiene.
Specifically hand hygiene
Chickenpox
(Varicella Zoster)
15-18 days
(Can be 10-21
days).
Direct person to
person contact –
airborne and droplet
spread.
High risk of transmission
from 2 days before rash
onset until all the lesions
have crusted.
Until vesicles become
dry (approx 7 days) but
a minimum of 5 days
after rash onset.
None if
asymptomatic.
Pregnant women and the
immuno-compromised
who are contacts of cases
should seek medical
advice as soon as
possible.
Clostridium
Difficile
Variable. Often
triggered by
antibiotic use and
can start a few
days or months
after antibiotic
course.
12 hours to 5 days
(Commonly 48
hours).
Contact with an
infected person or
contaminated
environment or
objects.
Those most at risk of
transmission are elderly,
people currently or
recently taken
antibiotics, been in
hospital or are
immunosuppressed.
High risk of transmission
during active infection.
Until clinically
recovered and
diarrhoea has ceased
for 48hrs.
None
Practice good hygiene,
specifically environmental
and hand hygiene.
If symptoms are severe
e.g. fever.
None.
Practice good hygiene.
Good cough etiquette.
2-12 days.
Direct contact with oral
High risk of transmission
None.
None.
Practice good hygiene.
Colds
Cold sores
HPT F059 04
Respiratory droplet.
Contact with
secretions.
Risk of person to
person spread
Recommended Period of Absence
Cases
Action
Contacts
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
(Herpes Simplex)
Route of Infection
Risk of person to
person spread
secretions or direct
contact with lesion.
until lesion crusted.
Recommended Period of Absence
Cases
Action
Contacts
Health education.
Avoid kissing and contact
with sores.
Mild self limiting.
Practice good hygiene.
If outbreak or cluster
inform HPT.
Conjunctivitis
1-3 days.
Contact with
discharges.
High risk of transmission
whilst symptomatic.
If unwell and a serious
infection stay off until
eye no longer inflamed
and infected.
None.
Cryptosporidiosis
7-10 days (can be
1-21 days average
7 days).
Faecal-oral.
Waterborne.
Contact with animal
faeces.
High risk of transmission
from person to person.
None.
Practice good hygiene.
Follow up by
HPT/Environmental
health.
Cytomegalovirus
(CMV)
Variable.
3-8 weeks but can
be up to 12.
Intimate exposure.
Contact with infected
tissue or fluids (e.g.
body fluids/blood).
High risk of transmission
through intimate contact
with fluids, whilst
organism present.
Carriage may persist for
many months.
Until clinically
recovered and
diarrhoea has ceased
for 48hrs. Avoid
swimming until 2
weeks after symptoms
cease.
None.
None.
Practice good hygiene.
Diarrhoea
Dependent on
causative
organism.
Often food or
waterborne or due to
poor hygiene.
Can be faecal-oral.
Some viruses may be
airborne.
High risk of transmission
whilst symptomatic,
though dependent on
cause.
Until clinically
recovered and
diarrhoea has ceased
for 48hrs. (If cause
known refer to
disease).
None
(If cause
known refer to
disease).
Practice good hygiene
(If cause known refer to
disease).
HPT F059 04
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Diphtheria
(very rare in UK)
Dysentery
(Bacillary)
Including
Shigella flexneri
Shigella boydii
Shigella dysenteriae
*Shigella sonnei
E.coli O157 (VTEC)
E.coli in urine
HPT F059 04
Typical Incubation
Period
2-5 days but may
be longer.
1-3 days
(Can be 8hrs to 7
days).
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
Action
Contacts
Contact with discharge
from lesions.
Airborne droplet
spread.
Direct contact with
respiratory discharges.
Infected animals or
unpasteurised dairy
products.
Not highly infectious.
Prolonged close contact
is normally required for
transmission. Cases
remain infectious for up
to 4 weeks after
symptom onset or after
3 days of appropriate
antibiotics.
Until clinically
recovered and
bacteriological
specimens are clear.
Always consult with
local health protection
team as exclusion will
apply.
Household
contacts
should be
excluded until
specimens are
clear.
Notifiable.
Investigation by HPT
Faecal-oral.
Food borne.
Occasionally
waterborne
High risk of transmission
from person to person
especially whilst cases
are symptomatic.
2 negative stool
specimens for groups
A, B, C and D taken at
least 48 hours apart.
None.
Unless
contacts are
symptomatic.
Notifiable
Practice good hygiene.
Follow up by EHO/HPT.
2 negative stool
specimens for
groups A*, B, C
and D taken 24
hours apart.
Otherwise 48
hrs symptom
free.
*All close
contacts 10
years and under
would be
excluded
None
Notifiable.
Follow up by HPT/EHO.
Practice good hygiene
Preventable by
vaccination.
Contact tracing will be
required.
* 48 hours symptom
free.
2-7 days
(Can be 1-14).
Unknown.
Faecal-oral.
Food borne.
Contact with animal
faeces.
Spread of the bacteria
Very high risk of
transmission from
person to person. Cases
can still pass on
infection once
asymptomatic and
contacts can carry E-coli
O157 with no symptoms
and pass it on.
Low risk of transmission
2 negative stool
specimens for groups A*,
B, C and D taken 24
hours apart.
Otherwise until clinically
recovered and diarrhoea
has ceased for 48 hrs.
*all children aged 10
years and under are
classed as group A and
would be excluded
Until clinically recovered,
Practice good hygiene.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
from the gut to the
urinary system.
from person to person.
usually 2-4 days. May
require short course of
antibiotics.
Fifth Disease
(Parvovirus B19 or
‘slapped-cheek’
disease)
13-18 days
(4-20 days).
Through contact with
respiratory secretions.
High risk of transmission
7 days before rash
appears until one day
after onset of rash.
Until clinically
recovered.
Food Poisoning
Dependent on
causative
organism.
Food borne.
Variable. Usually low
risk of transmission if
asymptomatic.
German Measles
(Rubella)
14-17 days
(Can be 14-21
days).
Droplet spread or
direct contact with
secretions.
High risk of transmission
from 1 week before
onset of rash to 4 days
after.
Until clinically
recovered and
diarrhoea has ceased
for 48hrs. (If cause
known refer to
disease).
Until clinically
recovered but at least
4 days after onset of
rash.
Giardiasis
7-10 days
(Can be 5-28 days).
Waterborne.
Faecal-oral.
High risk of transmission
whilst organism present
in stool.
Glandular Fever
(Infectious
Mononucleosis)
4-6 weeks.
Close contact with
pharyngeal secretions
(e.g. kissing).
Indirectly on hands.
Carriage may be
prolonged with high risk
of transmission.
HPT F059 04
Until clinically
recovered and
diarrhoea has ceased
for 48hrs
Until clinically
recovered.
Action
Contacts
None.
Pregnant
contacts
should seek
advice from
GP/Midwife.
None.
(If cause
known refer to
disease).
Pregnant women,
immunocompromised and
people with haemolytic
anaemia should avoid
contact with known cases.
HPT may
consider
excluding
contacts in
group B&D if
they are not
fully
immunised
with MMR.
None.
Notifiable.
Follow up of cases by
HPT.
Pregnant women should
consult their GP or
midwife if exposed.
Children should be
immunised with MMR.
Practice good hygiene.
Notifiable.
Follow up by HPT/EHO.
Practice good hygiene.
None.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
Contacts
None,
information will
be provided if
infection is
invasive
None.
HPT will follow up cases
of invasive group A strep.
When clinically
recovered. Until
blisters have healed.
None.
Report outbreaks to HPT.
Practice good hygiene.
Until treated. (After first
treatment and no
visible live lice).
Treatment only
recommended when
live lice are seen.
Until 7 days after onset
of jaundice (if present)
or other symptoms.
None if
asymptomatic.
Check
regularly with
combing.
Health education.
Practice good hygiene.
None unless
they have
symptoms
suggestive of
Hep A or are
food handlers
Notifiable.
Follow up by HPT/EHO.
Practice good hygiene.
Until clinically
recovered.
None.
Notifiable.
Investigation by HPT.
Group A
streptococcal
infection
1-4 days for acute
infection, 2-3 weeks
Person to person
Low risk
Until clinically
recovered and 24
hours after appropriate
antibiotics
Haemophilus
Influenzae B
(HIB)
Unknown but
probably 2-4 days.
Respiratory droplet or
contact with
secretions.
Until clinically
recovered but at least
48 hours after
commencing
treatment.
Hand, Foot &
Mouth Disease
3-5 days.
Direct contact with
faeces, blisters and
respiratory droplets
(aerosol droplet
spread).
Head Lice
Head lice mature in
6-12 days and live
for about 20 days.
Direct head to head
contact.
High risk of transmission
whilst symptomatic
and/or whilst organism
is present in
nasopharynx. Non
infectious after 48 hours
of appropriate antibiotic
treatment.
High risk of transmission
during acute stage of
illness (occasionally
longer as virus can
persist in faeces for
several weeks).
High risk of transmission
until adequately treated.
Hepatitis A
28-30 days
(Can be 15-50).
Faecal-oral.
Waterborne.
High risk of transmission
from two weeks before
onset of jaundice until
one week after jaundice
starts.
Hepatitis B
2-6 months
(Commonly 2-3).
Blood borne.
Mother to baby vertical
Infectious during incubation
period and up to 6 months
HPT F059 04
Action
Investigation by HPT.
Children should have
been immunised preschool.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Recommended Period of Absence
Cases
Action
Contacts
transmission.
Sexual transmission.
Sharing injecting
equipment.
after acute illness. 10% of
adult and up to 90% infant
cases develop chronic
infection and continue to
be infectious
Low risk of transmission if
social contact only.
80% of cases develop
chronic infection and
continue to be infectious
unless treated. Low risk
of transmission if social
contact only.
Virus present in faeces
during late incubation
and have been detected
14 days after onset of
jaundice. Does not
transmit readily from
person-person.
Infectious for life.
Low risk of transmission
if social contact only.
Until clinically
recovered.
None.
Notifiable.
Practice good hygiene
with care when dealing
with blood/body fluids.
Until clinically
recovered but all
should be reminded of
the importance of hand
hygiene.
None
Notifiable
Investigation by HPT/EHO
Hand Hygiene.
None.
None.
Notifiable.
Practice good hygiene.
take care when dealing
with blood/body fluids.
Highly infectious whilst
lesions are present and
until they are healed and
crusted over.
Until lesions are
crusted or healed or 48
hours after
commencing
appropriate antibiotics.
Until clinically
recovered.
None.
Report outbreaks to HPT.
Practice good hygiene.
None.
Immunisation for at risk
groups.
Hepatitis C
2 weeks to 6
months
(commonly 6-10
weeks)
Blood borne.
Sexual transmission.
Sharing injecting
equipment.
Hepatitis E
15-64 days
(Mean 26-42 days)
Faecal-Oral
Contaminated
food/water
Links to shellfish
HIV
1-3 months for
detectable
antibodies
Impetigo
Group A Strep skin
infection.
1-10 days.
Influenza
1-5 days.
Blood borne.
Sexual transmission.
Sharing injecting
equipment.
Mother to child vertical
transmission.
Direct contact with
lesions.
Indirect contact with
infected items (e.g.
towels, clothes).
Airborne/droplet.
Contact with
HPT F059 04
Risk of person to
person spread
Highly infectious in the
first 3-5 days (up to 10
Practice good hygiene,
with care when dealing
with blood and body
fluids.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Risk of person to
person spread
respiratory secretions.
Airborne.
Direct contact with
respiratory secretions.
days in young children).
Highly infectious from 5
days before onset of
rash until 4 days after
the rash develops.
2-10 days.
Commonly 3-4.
Direct contact.
Contact with
respiratory droplets
from nose and throat.
Mumps
16-18 days
(Can be 12-25
days).
Norovirus
(Winter vomiting
bug)
Recommended Period of Absence
Cases
Action
Contacts
Practice good hygiene.
4 days from the onset
of rash.
Contacts in
groups A and D
who are not
immune may be
excluded by
HPT for 21 days
after last contact
with the case.
Notifiable
Investigation by HPT
Children should be routinely
immunised with MMR.
Pregnant women and
immunocompromised should
seek advice from their
GP/midwife.
Low risk of transmission
person to person until
48 hrs of appropriate
antibiotic therapy.
Until clinically
recovered.
None.
HPT will
organise info
for contacts
and schools if
req.
Airborne/droplet
spread.
Direct contact with
saliva.
Medium risk of
transmission 7 days
before onset of
symptoms until 9 days
after.
None.
15-50 hours
(can be 4-77 hours)
Faecal-Oral
Aerosol transmission
Poliomyelitis
(very rare in UK)
7-14 days
(Can be 3-35 days).
Faecal-oral.
Respiratory
2-8 days average of
Exposure to
High risk of transmission
from person to person
and environmental
transmission.
High risk of transmission
when virus present in
stools and/or
nasopharynx.
High risk at onset of
Until clinically
recovered but no less
than 5 days from the
onset of
symptoms/onset of
swollen glands
Until recovered and
48 hours since
symptoms have
ceased.
At the discretion of the
duty Consultant in
Public Health Medicine
(CPHM)
None. Children can
Notifiable.
Investigation by HPT.
Meningitis ACWY
vaccination recommended
for 14-18 year olds and
University fresher’s. Men
B vaccine now also part of
childhood immunisation
schedule.
Notifiable.
Preventable by
vaccination with
2 X MMRs. Inform HPT if
outbreak suspected.
Measles
7-18 days (can be
up to 21 days).
Rash usually
appears 14 days
after exposure.
Meningococcal
Disease/Septicaemi
a
HPT F059 04
None
Inform HPT if outbreak
suspected.
None.
Notifiable.
Investigation by HPT.
Children should be
routinely immunised.
Practice good hygiene ad
None
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
syncytial Virus
5 days
Ringworm
2-6 weeks.
Rubella ( see
German Measles)
Salmonella
(excluding typhoid
and paratyphoid)
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
respiratory secretions
directly or indirectly
Direct skin to skin
contact with infected
person or animal.
Indirect contact with
fomites or
environmental
surfaces.
illness until 1week after.
12-36 hrs
(can be 6hrs to 7
days)
Faecal-oral
Contaminated food
High risk of transmission
when symptomatic.
Scabies
2-6 weeks if not
previously infected.
1-4 days if
reinfected.
Prolonged skin to skin
contact. E.g. hand
holding.
High risk of transmission
until adequately treated.
Scarlet Fever
1-3 days.
Airborne/droplet.
Contact with
respiratory secretions.
Direct contact with
patients or carriers.
Medium risk of
transmission whilst
organism present in
nasopharynx, although
minimal risk after 24
hours of appropriate
antibiotic treatment.
Until clinically
recovered and 24
hours after start of
treatment.
Shigella
(see Dysentery)
Shingles
(Varicella-Zoster
Reactivation of
Varicella infection
Direct contact with
lesions.
Moderate risk of
transmitting chickenpox
None if lesions can be
covered and are not
HPT F059 04
Medium risk of
transmission whilst
infected lesions are
present.
return to school when
clinically well
None, but lesions
should be covered.
None but until clinically
recovered and 48hrs
after diarrhoea has
ceased.
Until treated.
Can return after first
treatment.
Action
Contacts
good cough etiquette.
Families
should be
checked for
ringworm.
Avoid direct contact with
lesions.
Good hygiene practice.
None
Notifiable.
Follow up by HPT/EHO.
Practice good hygiene
All household
and close
contacts may
require
treatment
None.
Practice good hygiene.
Health education.
Contact HPT if two or
more cases.
None.
Can cause
Practice good hygiene.
Seek advice from GP or
None.
None. Antibiotics are
recommended for affected
children
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
Contacts
in the 7 days after the
appearance of lesions.
weeping. Otherwise for
7 days after onset of
lesions.
C.Pox in those
who have not
had chicken
pox.
None
Action
virus)
(chickenpox).
Staphlococcus
aureus infection
(MRSA/MSSA/PVL)
Variable and
indefinite
Contact with patients
with purulent lesions,
or with an
asymptomatic carrier.
Airbourne spread is
rare
High for certain groups
of patients, and if
patients have active
infection and there is
skin to skin contact,
poor hygiene or sharing
of personal items.
Special considerations
for Health care
workers: contact
occupational health.
Thrush
(candidiasis)
Variable.
2-5 days in infants.
Contact with
secretions from mouth,
skin, vagina and
faeces.
Vertical mother to child
transmission at birth.
High risk of
transmission.
None.
None.
Toxocariasis
Weeks or months
depending on the
severity of infection.
Ingestion of eggs from
contaminated soil,
hands or contact with
dogs (especially
puppies).
Not spread from person
to person.
None.
None.
Practice good hygiene.
Health education.
Toxoplasmosis
5-23 days.
Ingestion of eggs from
sand boxes/play areas
contaminated with cat
faeces.
Also from rare,
undercooked meats.
Not spread from person
to person.
None.
None.
Practice good hygiene.
Health education.
HPT F059 04
midwife if pregnant or
immunocompromised
HPT will only follow up
cases of PVL staph
aureus. Hand hygiene is
very important. Health
education should be
provided. Any active
lesions should be
covered.
Practice good hygiene.
Health education.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
Action
Contacts
Tuberculosis pulmonary
2-12 weeks
(Disease can be
“sleeping” for
decades).
Airborne/droplet.
Medium to low risk until
2 weeks after treatment.
Requires close
prolonged contact.
After consultation with
specialist physician the
TB nurse/CPHM will
inform the patient
about their return to
school.
At the
discretion of
the CPHM.
Notifiable.
Investigation by HPT.
At risk children should be
vaccinated as babies.
Tuberculosis non-pulmonary
Indefinite.
Not usually infectious.
Not usually transmitted
from person to person.
Until clinically
recovered.
None.
Notifiable
Investigation by HPT.
Typhoid and
Paratyphoid Fever
10-14 days
(Can be 1-3
weeks).
Food borne.
Waterborne.
Faecal/Urine-oral.
High risk of transmission
whilst symptomatic.
None unless
symptomatic in
Notifiable.
Follow up by HPT/EHO.
Practice good hygiene.
Viral Gastroenteritis
Dependant on
causative
organism.
Outbreaks followed up by
HPT/EHO’s.
Practice good hygiene.
Dependant on
virus.
High risk of transmission
during acute vomiting
and diarrhoea and up to
48 hrs after symptom
free.
Considered to be very
unlikely.
None.
Viral Meningitis
Until clinically
recovered (usually
within a week).
None.
If more than one case
then may wish to call HPT
for advice.
Practice good hygiene.
Vomiting
Dependant on
causative
organism.
Faecal-oral.
Airborne secondary to
environmental
contamination.
Food borne.
Dependant on the
virus. Person to
person spread usually
droplet spread or may
be airborne.
Often food or
waterborne or due to
poor hygiene.
3 negative stool
specimens 48hrs apart
if in a risk group
(starting one week
after antibiotic course
completed).
Otherwise 48 hrs
symptom free.
48hrs after symptoms
cease.
Until clinically
recovered and
symptoms have
None.
Outbreaks followed up by
HPT/EHO’s.
Practice good hygiene.
HPT F059 04
High risk of transmission
whilst symptomatic,
though dependent on
which case
should be
excluded until
symptoms have
ceased for at
least 48hrs.
November 2015
LOTHIAN NHS BOARD
HEALTH PROTECTION TEAM
Recommended Periods of Absence for Communicable Disease – School Pupils
Disease/
Causative
Organism
Typical Incubation
Period
Warts/Verrucae
2-3 months
(but can be 1-20
months).
Whooping Cough
(pertussis)
7-10 days
(Can be 5-21).
HPT F059 04
Route of Infection
Risk of person to
person spread
Recommended Period of Absence
Cases
Can be faecal-oral.
Some viruses may be
airborne.
cause.
ceased for 48 hrs.
Direct contact with
warts.
Verrucas may spread
in pools or showers.
Airborne/droplet.
Contact with
respiratory secretions.
Can probably be
transmitted at least as
long as visible lesions
present.
Highly infectious in early
stages of illness and up
to 3 weeks after onset of
cough (rarely 6 weeks).
None. Verrucae should
be covered in
swimming polls, gyms
and changing rooms.
Until clinically
recovered and 3 weeks
from onset of cough or
5 days of appropriate
antibiotic therapy.
Action
Contacts
None.
Practice good hygiene.
If symptomatic
see case
absence.
Notifiable.
Investigation by HPT.
Children should be
routinely immunised preschool.
November 2015